COPD Exacerbations, Costs, and Health Care Resource Utilization Before and After Initiation of Fluticasone Furoate/Umeclidinium/Vilanterol in Routine Care in the USA

Int J Chron Obstruct Pulmon Dis. 2023 Mar 24:18:407-418. doi: 10.2147/COPD.S378867. eCollection 2023.

Abstract

Purpose: To examine the impact of initiating fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in a single device on chronic obstructive pulmonary disease (COPD) exacerbations, COPD exacerbation-related costs, and all-cause and COPD-related healthcare resource utilization (HCRU) and costs in patients with COPD.

Methods: Retrospective database analysis of patients with COPD aged ≥40 years who initiated FF/UMEC/VI between September 1, 2017, and December 31, 2018 (index date: first pharmacy claim for FF/UMEC/VI), following evidence of multiple-inhaler triple therapy (MITT) (≥30 consecutive days) in the year prior to index. COPD exacerbations, COPD exacerbation-related costs, and all-cause and COPD-related HCRU and costs were compared between the baseline period (12 months prior to and including index) and follow-up period (12 months following index).

Results: Data from 912 patients (mean [SD] age: 71.2 [8.1], 51.2% female) were included in the analyses. Among the overall cohort, mean count of total COPD exacerbations (moderate or severe) per patient was statistically significantly lower in the follow-up period compared to baseline (1.2 vs 1.4, p=0.001). The proportion of patients with ≥1 COPD exacerbation (moderate or severe) was also statistically significantly lower in the follow-up period compared to baseline (56.4% vs 62.4%, p=0.001). All-cause and COPD-related HCRU were similar during follow-up compared to baseline, although the proportion of patients with COPD-related ambulatory visits was lower during follow-up (p<0.001). COPD-related office visit costs, emergency room visit costs, and pharmacy costs were statistically significantly lower during follow-up compared to baseline (p<0.001; p=0.019; p<0.001, respectively).

Conclusion: In a real-world setting, patients on MITT who subsequently initiated FF/UMEC/VI in a single device had significant reductions in the rate of COPD exacerbations (moderate or severe). Switching to FF/UMEC/VI also resulted in improvements in some HCRU and cost outcomes. These data support the use of FF/UMEC/VI among patients at high risk of exacerbation to reduce future risk and improve outcomes.

Keywords: FF/UMEC/VI; chronic obstructive pulmonary disease; exacerbations; healthcare utilization; multiple-inhaler triple therapy; single-inhaler triple therapy.

MeSH terms

  • Administration, Inhalation
  • Aged
  • Androstadienes / adverse effects
  • Benzyl Alcohols / adverse effects
  • Bronchodilator Agents / adverse effects
  • Chlorobenzenes / adverse effects
  • Drug Combinations
  • Female
  • Fluticasone / therapeutic use
  • Humans
  • Male
  • Patient Acceptance of Health Care
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Quinuclidines / adverse effects
  • Retrospective Studies

Substances

  • fluticasone furoate
  • vilanterol
  • GSK573719
  • Bronchodilator Agents
  • Fluticasone
  • Androstadienes
  • Benzyl Alcohols
  • Chlorobenzenes
  • Quinuclidines
  • Drug Combinations

Grants and funding

This study was funded by GSK (study number 213946). The sponsor was involved in study conception and design, data interpretation, and the decision to submit the article for publication. The sponsor was also given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations.